I guess my therapists (and my wife!) have been more understanding: they don't really press the point. It's like "I need breasts, I need SRS," and they say, "Then you should have them."
But the question has come up occasionally in therapy, so I had to think about it. My dysphoria was mostly social, and involved my presentation. Body dysphoria was secondary. But it was there.
A large part of my body dysphoria actually relates to my social and presentation dysphoria. I can't present convincingly as female unless my body falls within norms of female characteristics. I don't need to be beautiful, but I do need people to see me as a woman. Breasts were therefore necessary. Feminizing my face was necessary. Female-pattern hair was necessary. And, to a certain extent, having no externally visible genitals was necessary, all for my presentation.
Some of those things could be accomplished without altering my body, using forms, wigs, tucking, etc., but too much of that makes it feel like role playing. And role-playing is what I needed to get away from. My social dysphoria was about the dissatisfaction of playing the role of a male. I couldn't accept playing the role of a female. I needed to be real as a woman. HRT has given me much of what I needed there.
As long as I have the wrong genitals, my body feels wrong. I long for the proper, smooth shape. Not having it has social consequences for me. I need to be gendered correctly, and having a bulge in the wrong place makes that less likely. I have had no negative experiences, but I live in fear of someone seeing something they shouldn't through the crack in the stall door and making my life difficult.
I have been a gym member in my previous life, and have been to public swimming pools. Those activities are not a big part of my life, but I enjoyed them at the time and might like to do them again. I cannot use a public locker room with the hardware I was born with, so those activities are out of the question. I cannot relax on a beach without thinking about how I am going to cover up.
None of those things is a threat to my life. I am a survivor, so if they told me I couldn't have the necessary treatment, I wouldn't go and do something silly. But all those things do add up to a considerable weight on my mind. They are obstacles to being fully myself. I need to alter my body to fully be me.
Luckily, HRT has helped a lot. My breasts, while just little As, are real, and I take pride in not using forms when out in public. I am about being real, and they are. My face looks plausibly feminine, aside from the regular pre-electrolysis stubble. My hair is a goner, so I wear a wig. Real hair would be preferable, but there are women with worse alopecia than me, so it doesn't bother me too much.
I can tuck the boy parts to make myself look presentable when the clothing requires it, but that is uncomfortable. And I hate seeing myself in the mirror after a shower. The rest of my body looks not bad, but there are those bits that just shouldn't be there. Just seeing them puts me back in that boy-space that I tried so hard to get out of. I long to look in the mirror and see myself from the waist down, as well as above the waist.
So that's kind of long-winded and beats around the bush, but it is how I describe my body dysphoria.
